In the late 1990s Prof. Dieter Grob was asked by the cantonal government of Zurich, Switzerland, to conduct an outcome study about the results of surgical spinal interventions. The investigation was undertaken and handed over. Thereafter, neither feedback nor consequences
resulted.
This triggered the idea to conduct those projects with a specialist society like EuroSpine, the Spine Society of Europe and keep full control of the data.
In 2000, Prof. Max Aebi took over the direction of MEM-CED, the Maurice E. Müller Center for Education and Documentation. This institute with a research focus on medical registries, multicenter studies and outcomes research was later integrated into the University of Bern as Institute for Evaluative Research for Medicine (IEFM).
In cooperation with experts from EuroSpine, Spine Tango content and technology have been developed at the IEFM where its database and administrative center is located.
Being an initially purely surgical registry, Spine Tango was developed around one core questionnaire for primary and revision surgeries. It is accompanied by a second and very similar questionnaire for staged surgery and a short follow-up questionnaire.
All instruments are available in a scanable paper and online format and follow the three golden rules for medical registries: simplicity, simplicity, simplicity. The questionnaires can be completed in a minute or less and are suitable for documentation of all spinal pathologies, levels, accesses and surgical techniques.
With the outcomes movement and the increasing awareness for inclusion of the patient`s perspective, the Core Outcome Measures Index (COMI), originally proposed by R. Deyo et al. was developed by the working group at Schulthess hospital Zurich (AF Mannion, D Grob et al.) for back and neck pain (two separate instruments) and is now officially recommended as the outcome instrument of choice for the Spine Tango community. Similar to the physician based documentation, the COMIs are short and comprehensive and represent a minimal burden for the patients.
Since superiority of surgical versus conservative treatments are still unclear for many spinal disorders, a working group has initiated the development of Spine Tango conservative, a documentation form for the most important non-surgical treatment options. By doing so, the potential user community of the Tango is multiplied and it will become possible to compare surgical and non-surgical treatments and their outcomes in the framework of one and the same registry in the near future.